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suffering from a form of indigestion attributable to thestomach or upper parts of the small intestine when in realityit arises from the caecum itself. If cascal disturbance offunction continues both cascum and appendix suffer. Therewill be want of proper exudation of succus entericus in

quantity and in quality and lowering of the activity of thesolitary lymphatic glands which will no longer control thegerms which swarm in that cavity. The bacillus colicommunis, which is the surgeon’s terror, serves in its properplace a beneficent purpose in effecting the disintegration ofsome of the undigested matter but when uncontrolled by thehealthy organs and their exudations is apt to cause ravagesin the tissues and to produce toxins which are lethal.If from inhibition of the appendicular and caecal movementsor the want of exudation of the succus entericus or if thecascum receives material which the succus entericus cannot

digest a stasis occurs in the contents of the csecum and theconstipation which is so often a feature of the appendicitisensues. At a later stage fermentative disintegration of thefascal contents with absorption of toxins and damage to thewall of the parts are apt to ensue. These are followed bydiarrhoea which is sometimes curative.

Doubtless the appendix and csecum are affected togetherbut just as pyogenic organisms affecting the throat spreadby continuity of structure to the middle ear and mastoidcells and produce serious damage there long after the throathas healed, so the appendicular inflammation once started

may continue to produce serious effects within the appendixafter the cascum has recovered from the primary effects. Asto prevention of appendicitis there are some lessons to bederived from the foregoing. Primitive man had to search forhis food and sometimes he had a hard physical fight to get it.When he found it he had been looking forward to it, was fitfor it, and enjoyed it ; consequently he had an abundant flowof all the digestive juices which were ready to receive thefood and to give it a warm welcome. Present-day man is saidto be in an evolutionary stage. With his indoor occupationsand his ever-engrossing mental pursuits he forgets that hehas to live and that in order to do so he has to eat and to

digest and that his duty to himself and to the community isto do both well in order that he may continue in health. Butfrom the way prevalent in many places he seems to act as iffood should be thrown into the stomach as a sandwich intoa pocket and the lid closed. Then he wonders that he has

indigestion and appendicitis. Though in a sense digestion isindependent of the direct control of the brain, yet powerful ’,mental impressions exert an influence over the glands con- ’cerned in digestion-from the salivary down to the glands of ’’,Lieberkiihn in the cascum and appendix. The mental influence ’,is such that when the mind is engrossed in other affairs than ’,the taking of food those gland secretions are apt to be scanty Iand indigestion is apt to follow. If a person is mentallyengrossed he ought to refrain from eating or to eat very Isparingly. The standing lunch, eaten against time while the ’’

mind is fully occupied with business or professional examina-tions, the food instead of being chewed and mixed with salivabeing simply washed down as a bolus with some fluid, is oneof the best ways of not only producing indigestion but ofultimately causing cascal and appendicular mischief. Manhas neither got a crop like a bird nor a cascum like a horseand therefore he has no provision for bolted food. One hasheard of children being forced to take foods which they dis-like because "it was good for them." The digestive juiceswill not flow in such circumstances. The brain of childrenis often so burdened with " tasks " committed to memory andengrossed with educational enigmas that there is no timefor digestion. Mastication is not taught in schools,digestion has no place in national education, and thereare no certificates given for sound digestion ; but we

appoint instead Royal Commissions to inquire into thecauses of the physical deterioration of the race. Althoughthe caecum aids in digestion it does so by receivingpartially digested food which contains the proper amountof secretions from other glands. It does compensatesomewhat for their defects but cannot do so entirely.Therefore, it is a matter of great moment to commence thedigestive process well. A free mind, with the prospect ofenjoyment of food, thorough mastication until the saliva isefficiently mixed with the food, and then the process of

gastric digestion will have a good beginning and the foodthus prepared will be received in due course with abundantdigestive juices in the other parts of the canal. At a con-sultation on one occasion the lady of the house (French byorigin), who was not a patient, being: in perfect health,

twitted the local Scotch medical man with the rainy weatherthey kept in Scotland. He replied : " But, my lady, it seemsto suit you as you are always in good health."

"

"Yes," shesaid, "thanks to you, doctor, you always keep me in goodhealth." The medical man laughed and explained that thelady always asked for advice but never took the medicine.The lady said that at least she always had the prescriptionmade up, that it was the same wherever she went-

London, Paris, or elsewhere-she consulted the best autho-rities and had a general chat with them about her condi-tion and how best to maintain health and when theywere good enough to give her a prescription she hadit made up and dated and placed both prescriptionand drug in a cabinet made for the purpose. But, sheadded, "Indeed, I have never been ill. I believe the

greater number of maladies arise from indigestion and thatindigestion occurs mainly from too fast eating, whereas I eatslowly and many times I am ashamed as I am the last to

put down my fork." There was a method in that lady’smadness.For many years I have believed that the caecum and

appendix are of value in digestion. The facts pointing inthat direction have accumulated slowlv and are not all

garnered. Many require still to be investigated. One wouldhave preferred to wait until they were gone over again,re-tested, and either verified or dropped out. But "artis so long " that I have ventured to present you with anunfinished picture which I hope some of you will be able tocorrect and to finish. What has been said is merely a con-tribution to the subject. In dealing with it in the futureremember what Huxley sav s : Let us sit down before factas a little child, be prepared to give up every preconceivednotion and to follow humbly wherever nature may lead.

- Ke/isrecss.—Lectures of Professor Pawlow ; translated bV W. H.Thompson. (Charles Griffin and Co. London. 1902.) R. M. Smith:The Physiology of the Domestic Animals. (Philadelphia. 1889.)

An AddressON

THE FUTURE RELATION OF KINGSCOLLEGE TO ITS MEDICAL

SCHOOL AND HOSPITAL.Delivered at King’s College at the Opening of the Medical

Session on Oct. 4th, 1904,

BY THOMAS BUZZARD, M.D., F.R.C.P. LOND.,CONSULTING PHYSICIAN, NATIONAL HOSPITAL FOR THE PARALYSED

AND EPILEPTIC, QUEEN SQUARE; MEMBER OF THE SENATE OFTHE UNIVERSITY OF LONDON; FELLOW AND MEMBER

OF THE COUNCIL OF KING’S COLLEGE.

GENTLEMEN,-Before proceeding to addres&bgr; you on thesubject of the future relation of King’s College to its

medical school and hospital I should like to say a few wordsupon the more general topic of the medical life and practice.And first let me congratulate the students who have beenwinners in the competition for the highest distinctions

awarded in the medical department, and have received

to-day the welcome recognition of their industry and ability.There is no need for me to enlarge upon this. The legitimatesatisfaction at their success which they must feel is far and

away more grateful to them than would be any words ofmine. But I should like to remind those of my hearers whohave industriously competed without in the end finding aplace in the list of the more fortunate recipients that theycannot be described as "losers." They are simply "non-winners," and indeed, so far from having lost anything, itis certain that they have gained very much, for the timeexpended in working cannot but be attended with infiniteadvantage to themselves. It has been wisely said that "thereward is in the race we run, not in the prize." Nothingcan deprive them of the precious service to their own mentaldevelopment rendered by their hours of industrious occupa-tion and the last thing they would desire or need from uswould be any expression of condolence.

It would be a truism to say that the medical students of

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this college are on the threshold of an honorable profession.Speaking as one who has been a member of it for very manyyears I should like to say for their encouragement that I

believe they have chosen well. They will have the

opportunity of living the fullest, and it will be theirown fault if it is not the most useful, of lives. Whatbetter has existence to offer than this? I took myplace as a first year’s student in this college on theoccasion of an introductory address by the late Dr.

Todd, and of all the many sentences which fell from hissilver tongue there is but one which I now remember, andthat was a quotation, "To scorn delights and live laboriousdays" ; and the words were applied, of course, to a medical.career. The aptness of the latter part of the quotationcannot be denied. There is probably no more laborious lifethan that of a medical man and doubtless in the sense inwhich the words were employed by the poet (as will beacknowledged by those who remember the context) theformer half is also true. But I am ready to assert withconfidence that in no walk of life can the highest forms ofdelight, those which belong to the acquisition of knowledgeand those which never fail to attend the faithful perform-ance of duty, be looked for and found more certainly thanin that upon which many of those before me are now enter-ing. Did time permit I would gladly pursue this generaltopic-one upon which the experience of a long and activeprofessional life probably gives me some authority to dwell-but I will content myself with saying a few words upon apractical point which may perhaps prove useful to some ofthose whom I am addressing.

I would earnestly counsel all those who have the oppor-tunity-and there must be very few who have not-to aimat the highest-not to be satisfied, I mean, with that

qualification for practice which is most easily obtained.Addressing as I am an assembly of medical students, themajority of whom are probably intending to enter familypractice, I would point out to them that in these daysgraduation at a university is in the air. The times have

passed when it was only necessary in our profession forthe consulting physician to obtain a degree. In such

greater numbers every day are family practitioners adopt-ing this course that one need not be possessed ofany gift of prophecy to say that in a few years thosewho are without a good medical degree will lag behindin the race for success and still more so for distinc-tion. As is well known, Cambridge and Oxford are

attracting large and increasing numbers. The more

recently founded and important universities in our northerncounties are providing admirable facilities for students

coming from the provinces. London, however, with its un-rivalled resources for clinical teaching and experience, mustin the future become more and more the most esteemedeentre of all for the acquisition of medical knowledge. Inits lately developed form the University of London is, if Iam not mistaken, certainly coming to occupy the highestplace in the education of the medical profession. The well-

recognised esteem in which its medical degrees have alwaysbeen held has suffered no diminution since the change in itsconstitution, whilst the direct representation on its Senateof all the most important colleges and public bodies inLondon has vastly increased and widely extended itsinfluence upon education. I should certainly advise everystudent I am addressing to aim at obtaining a degree in theFaculty of Medicine of the University of London.As I said before, graduation is in the air. The time is

rapidly coming when members of all professions will

naturally be expected to hold a university degree. It isnot so many years since it was a rare exception for asolicitor to have graduated at a university and as for theengineer or the architect they were practically never seen inthe ranks of university graduates. All this, as we well know,is changing daily. Even in the military profession gradua-tion is asserting its influence and the Army Council is

arranging with the universities to carry on military educa-tion during the undergraduate period, granting a com-

mission upon examination to selected candidates whenthe degree is taken, and antedating it by a twelve-month to the recipient of honours. I say that youcannot afford to lose the opportunity which you nowenjoy of taking a London degree. I daresay it will appearto many of you impossible that you can ever require it.That is what you cannot possibly foresee. I have the bestof reasons for knowing that the possession of the Londondegree may make a vital difference in the whole career of

him who holds it. Nor is the advantage of it at all confinedto consultants. I was consulting a few weeks ago with avery able practitioner of medicine in one of the Londonsuburbs and observing that he held the M.D. London degreeI asked him if he thought that this had made any differenceto him. He did not hesitate but said that it had made allthe difference in the world to him. He was junior partner ina firm of three of which the two others were also graduatesof London and he would not have been permitted to jointhem but for his possession of a London degree. He told mealso that in his experience the public were steadily learningto appreciate the value of these degrees. Nor are there

wanting signs that the State is likely in the future to availitself more and more of the services of high-class members ofour profession in public duties, especially perhaps in the

investigation of the causes of disease in various parts of ourworldwide empire and in the organisation of measures fortheir prevention and treatment. For such appointments themark of higher education which is furnished by the

possession of a London degree cannot fail to be of greatvalue. I would remind those now entering that thecurriculum is of the same length, five years, both for a

London degree and the Conjoint diploma. Let them try, ifthey will, for both. They will have to work extremelyhard there is no doubt. So much the better. I feelinclined to repeat what President Roosevelt says in one ofhis addresses, "Your work is hard. Do you suppose Imention that because I pity you ? 7 No, not a bit. I don’tpity any man who does hard work worth doing."Are the London degrees obtained with any more ease than

was formerly the case ? 7 I do not think so. Perhaps thelarger choice of subjects in the matriculation examinationmay facilitate matters a little. A little grace, too, is

given in another direction. In the general preliminaryscientific examination a student may be examined in eachof the three subjects separately. Students who have failedin one or more subjects of the examination may offer them-selves for re-examination in these subjects, either separatelyor together, at any subsequent examination. And in the

general intermediate examination in medicine students whohave failed in one subject only may offer themselves forre-examination in this subject if permitted to do so by theexaminers. Personally I should be inclined to extend suchfacilities and to favour the candidate being allowed to takehis subjects in a somewhat piece-meal fashion. It isamusing to see a juggler keep half a dozen balls in theair at the same time but there is no particularuse in the achievement. The necessity of passingin several subjects on one and the same occ3:ion dis-

poses, I think, to cramming and in my judl2mcnt shouldbe discountenanced. It may probably be taken that theLondon degrees are at least as valuable as they ever wereand no less difficult to obtain. Can it be doubted that astudent should strain every nerve to obtain such a distinc-tion ? 7 It has been said that a severe examination alwaysexcludes fools and sometimes excludes persons of genius. Iwould commend the consideration of the latter alternative tothose who have the misfortune to fail.Let me turn now to the topic upon which I have

promised to say a few words. It will be readily understoodthat the approaching removal of our hospital to Camberwellhas necessitated the most careful and anxious considerationof the relations which should subsist in the future betweenthe College and its Medical School. The disadvantagewhich has always to some extent been felt in the past fromthe circumstance that the school and the hospital were notunder the same roof (as is almost invariably the case withthe medical schools generally) would naturally be muchintensified by the greatly increased distance between themunless measures could be taken to obviate the difficulty.It was at once evident that with a distarce cf nearlyfour miles between the College and the mw hospital con-tinuance of the Medical School on existing lines was notpracticable. In certain respects, too, it must be remembered,the step we are about to take is unexampled in themedical history of the metropolis. It is true that hospitalswithout medical schools have before now been transferredsuccessfully to new sites. And we have also the example(I think a solitary one) of St. Thomas’s Hospital (possess-ing, as we all know, a very important medical school),which was removed from the Borough to its present positionin Lambeth after a temporary sojourn in the Surrey Gardensat Walworth. In that instance the school along with thehospital was successfully removed, and possibly there are

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those who would say that there is no reason why we shouldnot simply imitate the example which has thus been set. Ithink I can show you why this is out of the question. Inthe first place, since the old days when St. Thomas’s Hos-pital was in the Borough, 40 or more years ago, a great changehas come over the academical arrangements for the educa-tion of the medical student. At that time (and I am

speaking of things within my personal knowledge) the oldidea of "walking the hospitals" as representing the first

step to be taken in medical education had not altogetherdied out and the notion that the student ought to pre-pare himself by some years of scientific study to profitby the opportunities of clinical experience at the hospitalhad not advanced into practical working. Accordinglythe student of medicine entered the wards of the hospitalon the day that he joined a medical school. In some casesthis would be only a month or two after he had ceased tobe a schoolboy. In many instances he would have passedsome years as an apprentice dispensing his master’s pre-scriptions. The expression "preliminary and intermediatestudies" was then unknown. In these days, as is wellknown to the teachers though the fact may not be widelyrecognised by the public, the student does not make, or oughtnot to make, his appearance in the wards of the hospitaluntil he has been for some two years or more studying andhas passed examinations in a number of scientific subjects.Sometimes, it is true, he rmy put in a little work as

an out-patient dresser or clerk. But this, I understand, israpidly becoming a ’thing of the past and his appearance inthe hospital itself in the earlier half of his education is nowin some institutions forbidden and in all discouraged. Forthat reason alone the removal of our medical school to

Camberwell, so far as the preliminary and intermediatestudies are concerned, with the necessary vast expendi-ture which would have to be incurred in connexion withlectura rooms, apparatus, laboratories, &c., would clearlybe motiveless. It will not bear a moment’s contempla-tion.But there is also another and a yet more convincing

reason. King’s College, on account of its science facultyand because of its recognition by the University of Londonas a complete collegiate institution, must in any eventstill retain the teaching of these purely scientific subjects,and it is in the college itself and not in the hospitalthat they must be taught. It must be rememberedthat this is not simply a question of a hospital linked onto which is a school of such scientific subjects (and thoseonly) as concern the medical student. King’s College isan institution which may be described as of universitycharacter. It possesses faculties of theology, arts, science,engineering and applied sciences, and medicine, besideshaving a women’s department and a boys’ school. A verylarge and important professorial staff has to be maintainedfor the service of the various faculties, and the medicalstudent who enters here has the great advantage of sittingunder professors whose business in life it is to teach the par-ticular subjects in which their eminence is acknowledged.The only oth er institution in the metropolis with which it iscomparable is University College. These two colleges aredescribed in the University of London Statutes as " Schools ofthe University in all the faculties in which they respectivelyafford instruction." The medical schools of the metropolisgenerally are designated "Schools in the Faculty of Medicine."There is no necessary obligation for the schools in the

Faculty of Medicine to concern themselves with the teachingof the preliminary and intermediate studies. It is notoriousthat the burden of provision for the teacliing of such subjectshas often been, and is now in many instances, a grievous one.There has never been any financial advantage in it. On thecontrary, it signifies a constant outlay upon the variousrequirements for the exposition of the subjects and this,with the progress of science, is becoming, and cannot failstill to become, a more and more serious demand. It meansthe absorption of space which would be of the greatestpossible value in supplying the needs for properly teachingthe essentially hospital studies. It means that very oftena man whose abilities lie in the direction of medicine orsurgery rather than in that of pure science and who isconscientious in his work, spends a large amount of time incultivating his knowledge of and teaching a subject thepursuit of which, whilst it is of no use whatever to him,probably displaces research in another direction which mightbe of great service to the science or art of his profession.How much b 3tter it would be if this work were undertaken

by those who have made tl e study of these sciences theirlife work and the teaching of them their profession.

It is easy to understand how the medical schools havealmost insensibly piled up on their shoulders the burden underwhich many now groan. The task of supplying such require-ments in the old days was not a very severe one. But yearby year the difficulty has increased until it has become well-nigh insupportable. The process, no doubt, has been a verygradual one, and in the earlier days indeed the idea offobtaining elsewhere than in the hospital the necessaryteaching of more or less preliminary subjects did not.enter into consideration. A young man entered at one-

of the hospitals and found there, as he expected, all that he-needed for each step in the process necessary for acquiringa degree or diploma. The idea of going outside the hospitalfor any part of his education was practically never enter-tained. All that is now changed. The student of medicine-

may obtain, and as a matter of fact frequently does obtain,the teaching of such subjects as chemistry, physics, andbiology where he likes so long only as he conforms to the.regulations of the examining body by which his knowledge is.to be tested. It is also notorious that the large majorityof the students who pass their examinations in the earlystudies at Cambridge or Oxford up to and including anatomyand physiology come to London for their hospital studies.and enter at any hospital they may choose to select. The-idea that the student should necessarily carry out his "hos-pital studies art Oxford or Cambridge is never contemplated.In the case of the many London students who do not go-to the older universities and whose aim it is to obtain a,

degree at the University of London or the diploma of theConjoint Board, it is evident that King’s College has peculiaradvantages to offer as a school for the preliminary and inter-mediate studies. Owing to its constitution as a complete,collegiate institution it is necessarily equipped in its sciencefaculty with all the requisites for education in the purelyscientific subjects-those studies which have to be completedbefore the student need determine at which hospital he willenter to carry out his advanced or hospital studies. How to.extend these advantages and to turn them to the best accountin the new departure in which we are engaged has occupiedthe very earnest consideration of the council, in which it hasreceived most valuable help from the professorial staff of the-medical department.

It has appeared to us probable that some of the medicalschools of the metropolis who wish to rid themselves ofthe incubus of providing education in the preliminary andintermediate studies (which, as I have said, is really no-

necessary part of the work of a medical school) might be-glad to come to some mutual arrangement by which King’s.College would carry out this portion of the curriculum inits science faculty, leaving the student free at its closeto complete his education by pursuing the advanced studieselsewhere. So long as King’s College continued, as inthe past, to receive practically only those students who.intended to carry out their whole professional educationunder its wing it would, I need scarcely say, have beenuseless to expect that other schools would send theirstudents to it for the early studies. In our new departure it,is recognised that King’s College, by the peculiarity of its

constitution, has probably an increasingly important partto play in the education of the student in the earlystudies provided that the interests of the other’ medicaLschools are properly safeguarded. Surely this should not be-beyond the reach of arrangement. I believe I am correctin stating that University College is proceeding on similarlines. By a curious coincidence the first two colleges of theUniversity of London-University and King’s-find them-selves simultaneously, the former by its forthcoming incor-poration with the University and the latter by the impend-ing removal of its hospital to Camberwell, in an unusuallyfavourable position for completely separating the departmentfor the later medical studies from that which is concerned onlywith the preliminary and intermediate subjects. In each casethe arrangements for teaching these latter will be so ordered-that they will be able to be made use of by as many of theother schools as may desire to do so consistent with the-amount of accommodation they are in a position to afford.The Institute of Medical Sciences projected by the Senate.of the University will provide, in process of time and whenthe very large amount of funds requisite for the purpose are.obtained, a third centre of the kind.

It has recently been suggested by a very eminent authoritythat a centre for the preliminary and intermediate studies.

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would be necessary on the south side of the Thames. Iconfess that I am quite unable to agree with him as to thisrequirement. These earlier studies are acknowledged to beindependent of hospital association-witness the number ofstudents who obtain their teaching in them at Oxford andCambridge. The mere circumstance, therefore, that therewill presently be three large general hospitals on the otherside of the Thames can have no possible bearing on thematter. Surely the more central and easily accessiblethe place for these studies the better. The very largecost, too, of founding such an institution would be amost serious objection even if the scheme were otherwisedesirable.Without venturing to enter upon details the considera-

tion of which would be evidently premature at this momentand might possibly be misleading, I think I may sketch

very broadly for your information and interest what is pro-posed to be done by King’s College. In the first place,except as regards the name, there will be a complete andentire separation of the hospital from the college. It isdesired that, as far as possible, this separation should takeeffect at an early date. Accommodation will not be providedat the new hospital for any of the preliminary subjects, in-cluding under this head physics, chemistry, zoology, botany,anatomy, physiology, materia medica, and pharmacology.These subjects will all be dealt with at the college, as,indeed, they are at the present time. With the exception ofanatomy, materia medica, and pharmacology, the subjectsin question already form part of our Science Faculty andcould not therefore be removed from the college even wereit desirable. Anatomy will be retained as a preliminarysubject at the college, where adequate accommodation is iprovided, and it will be transferred from the Faculty of

’’

Medicine to that of Science. Physiology, practical physio-logy and histology, together with experimental psychology,will continue to be taught at the college in the Faculty ofScience. The laboratories of experimental pathology andalso of neuro-pathology cannot conveniently be transferredto the new hospital, for the council and hospital staff areagreed that original researches in these subjects which mayinvolve experiments on living animals shall find no placewithin its walls. The teaching of State medicine will becontinued in the college. Accommodation will be providedat the new hospital for teaching each and all of the follow-ing subjects : medicine (including advanced therapeutics.diseases of children, and psychological medicine), surgery(including operative surgery and surgical anatomy), obstetricmedicine and gynaecology, pathology (including general patho-logy, bacteriology, pathological anatomy, and clinical patho-logy), forensic medicine (including toxicology), hygiene (bylectures only), the more special clinical subjects (includingophthalmology, otology, laryngology, rhinology, dermato-logy, and odontology), the administration of anaesthetics.orthopaedics, and x-ray and cognate work. It is intendedthat opportunity should be provided for the study of opera-tive surgery at the college as well as at the hospital. Generalpathology and bacteriology will be carried on at the hos-

pital as well as at the college under conditions which arenot yet quite determined. Such is a brief statement of thearrangements for teaching which are in contemplation.In view of the intended absolute separation of the hos-pital from the college it is proposed that no member ofthe new hospital staff shall retain his position as a

teacher of a preliminary or intermediate subject at thecollege. For the same reason composition fees will beabandoned and the student who has entered at King’sCollege for the early studies will not be unduly tempted toproceed to the Camberwell Hospital for his advanced studiesby any advantageous financial arrangement. He will be

absolutely free to select for his advanced studies the hospitalwhich attracts him most. Just as it is believed that therewill be many students at the new hospital who have neverbeen near King’s College, so it will be open for any studentsentering at King’s College for the early studies to close theirconnexion with the college when these are finished andpursue their advanced studies at the hospital of their choice.At all events this is our aim. Although from considerationsof sentiment it is evidently imperative to retain the name of" King’s at the new hospital, yet our purpose is that thesetwo institutions, the college and the hospital, should standto all intents and purposes independent of one another, eachprepared to provide for any student of medicine who appliesthe opportunity of study in the particular subjects of hisrequirement.

An Introductory LectureON

THE EVOLUTION OF THE MEDICALCURRICULUM.

Delivered at St. George’s Hospital on Oct. 1st, 1904,

BY ALEXANDER MACALISTER, M.A.,M.D. CANTAB., F.R.S.,

PROFESSOR OF ANATOMY AT THE UNIVERSITY OF CAMBRIDGE.

GENTLEMEN,-There is a certain fitness in the coincidenceof the season of introductory lectures with that of the fall

of the leaf. Lectures and leaves are both structures mani-

festing design and order and both are destined, after an

3phemeral existence, to the oblivion of the rubbish heap.Here the analogy ends, for while the material of the decay-ing leaf serves as a fertiliser to promote new life there is

only a remote possibility that the substance of the lecturemay be instrumental in developing fresh lines of thought.Still, as the wisdom of the age has decreed the persistenceof this ancient rite of initiation into the mysteries of

medicine, it behoves those to whom the conduct of thisordeal is committed to perform their task with all availablecraft.There are divers species of introductory lectures : the

leading types are the didactic, the hortatory, the remini-scent, the biographical, the facetious, the historical, and thediffuse or indefinite, but there is .one common feature in

all-they begin by an expression of welcome to those whoare entering upon professional study. Following precedent,I commence by congratulating you upon your choice of ahospital. St. George’s stands in a prominent position withpleasant environment and I am happy to state that it is toremain in this favoured locality. The governors have

decided, at a meeting holden on June 21st last, not to removethe hospital from the site which it has occupied for a centuryand three-quarters. Around this place there cluster memoriesof many distinguished men who have taught and learned here,among whom there are not a few who are of world-wide fame.I need only mention Cheselden, John Hunter, BenjaminBrodie, Matthew Baillie, and Thomas Young, but the list

might be, if necessary, lengthened ; and at no time was thehospital better equipped or better manned than at present.In this connexion I have a melancholy duty laid upon me torefer to the sad loss which the hospital has suffered by therecent sudden death of one of the most esteemed members ofthe staff, Dr. W. Lee Dickinson, senior assistant physician.Dr. Dickinson came of an old and renowned medical stock.His maternal grandfather, Dr. J. A. Wilson, son of the

anatomist, was physician to this hospital, as was also hisrespected father, who retired from the staff in 1894. Iremember Dr. Dickinson very well in his Cambridge days asa distinguished student at Caius College. He devoted him-self to physiological research, and collaborated withProfessor Langley in experimental work on peripheral nerveganglia and other branches of nerve physiology and patho-logy. Graduating in 1890 he served this hospital successivelyas medical registrar and curator of the museum, coming onthe staff as assistant physician in 1894. Ever zealous anddevoted to his work he earned the affection and esteem ofthose with whom he was associated as colleague and teacher.In spite of the failure of his health he continued bravely todischarge his duties until within a few weeks of his death,which took place on Sept. 6th. We all to-day unite in thetribute of grief for the untimely removal of an earnest anddevoted man from our company.The example of the life of such a one would in itself be a

theme upon which it would be profitable to enlarge, and heis only one out of the long succession of those wnohave served the hospital, the profession, and humanity withhonour and faithfulness. Had I ventured to make thisaddress biographical, I should have found some difficulty onaccount of the embarrassment of riches in selecting any onename out of the many " on Fame’s eternal bead-roll worthyto be filed." I have therefore chosen to speak upon anothertext. But before leaving the realm of biography I am